Creating a New Generation of Doctors with Interest and Expertise in Tourette Syndrome

The Rutgers Tourette Clinic at the Graduate School of Applied and Professional Psychology

One of the biggest problems associated with Tourette Syndrome is that too few psychologists, mental health professionals and other healthcare practitioners know enough about TS to help the many individuals and families dealing with this often devastating neuropsychiatric disorder.

The current class of graduate students with Clinic Director Graham Hartke, Psy.D

“It took seven years to get a diagnosis for my son,” said Faith Rice, founder and Executive Director of NJCTS. “You see doctor after doctor but finding the one who understands, truly has the knowledge of the disorder, was like finding a needle in a haystack.”

The NJCTS Tourette Syndrome Clinic (TSC) and Practicum Program at Rutgers University’s Graduate School of Applied and Professional Psychology (GSAPP) was created to help close that gap and give those individuals and families a place where they not only could seek treatment, but also feel reassured that the clinicians administering the treatment have a strong knowledge base. The TSC is the nation’s only university-based, stand-alone, student-clinician teaching practicum and clinic for the psychological evaluation and cognitive-behavioral treatment of TS in the nation.

“We approached Rutgers in the early 2000’s with the idea of creating a training program for doctoral candidates and perhaps even a clinic that would see patients and their families,” said Rice. “After more than two years of discussion with professors, directors and the Dean, they agreed to pilot this one-of-a-kind program. NJCTS’s thinking was that doctoral students would train for months before they saw patients but Rutgers had a different idea. They wanted their doctoral candidates, with close clinical supervision, to see clients right away – while they were learning the ins and outs of TS.”

The concept and clinic were a success from the start – families were treated individually, they became part of support groups, the kids benefitted from social skills training and the doctoral students became involved in advocacy for their clients. The clinic soon became one of the most sought after “practicums” in psychology at Rutgers and four years into the partnership was awarded the Rutgers President’s Award for Innovation.

Since the clinic opened over 15 years ago, more than 70 psychologists have been trained, including its current director Dr. Graham Hartke, Psy.D. Clients consist of children, adolescents and adults with tics, and the parents and other family members of individuals with TS.

The clinic specializes in providing diagnostic assessment and cognitive behavioral therapy (CBT) with a focus on evidence-based interventions, including Comprehensive Behavioral Intervention for Tics (CBIT). The American Academy of Neurology’s current guidelines for treating tics recommends doctors first consider prescribing CBIT before considering medication and other therapeutic treatments.

“We specialize in treating individuals and families with TS, OCD, ADHD, and other associated conditions, using Cognitive Behavioral Therapy (CBT),” Dr. Hartke said. “Treatment at the TSC is tailored to the unique needs of each individual and family, with a focus on improving symptoms and teaching proactive skills. Our hope is to turn the treatment over to the families, so we teach them skills of how to manage the behaviors at home.”

Clinic therapists are advanced doctoral students from the Rutgers GSAPP clinical and school psychology programs who are trained and supervised by Dr. Hartke. The program provides a unique, hands-on learning experience for students striving to increase awareness of TS in the professional community. In addition, research obtained through the observation and treatment of children and families provides important insight into the needs of the TS community and evidence-based treatment approaches.

Doctoral students also participate in NJCTS programs including in-services, family retreat weekend and Leadership Academy to improve their understanding and ability to treat families living with TS. Many graduates of the program continue to be involved with NJCTS by presenting at hospital grand rounds and teacher in-services and by making themselves available to families through the NJCTS Physician Referral List.

“These graduate students are future practitioners for individuals with Tourette Syndrome, an area of psychological care that currently has few specialists,” said Rice. “The more psychologists that we can train, the easier it will be for families across the country to find the treatment they need.”

GSAPP students with Youth Advocate Ethan Lederman, his mom Tracy (left), and Dr. Rob Zambrano (center).

To schedule an appointment with the TS Clinic, please call 848-445-6111, ext. 40150, or email tsc@gsapp.rutgers.edu. The offices are located on the Livingston campus of Rutgers University in Piscataway. Assessments usually require 2-3 sessions, each of which are approximately 1-hour long. Once an assessment is complete, the clinicians develop a treatment plan in collaboration with the individual and/or parents to best meet the goals set forth in the assessment. The program offers sliding scale rates for individuals and families with demonstrated financial need.